title: Clinical profile and outcome of chronic pancreatitis in children.
abstract: OBJECTIVE
  To evaluate the etiology, presentation, complications and management of chronic pancreatitis in children.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Gastroenterology department at Christian Medical College and Hospital, Vellore, India between January 2005 and December 2010.
  
  
  METHODS
  99 Children (>18 yrs) diagnosed with chronic pancreatitis based on clinical and imaging features.
  
  
  METHODS
  Etiology, clinical presentation, complications and management of chronic pancreatitis in children.
  
  
  RESULTS
  Of 3887 children who attended the Gastroenterology department, 99(2.5%) had chronic pancreatitis, of which 60 (60.6%) were males. In 95(95.9%) patients no definite cause was detected and they were labeled as Idiopathic chronic pancreatitis. All patients had abdominal pain, while 9(9.1%) had diabetes mellitus. Of the 22 children tested for stool fat, 10(45.5%) had steatorrhea. Pancreatic calcification was seen in 69 (69.7%). 68 (71.6%) patients with idiopathic chronic pancreatitis had calcification. Calcific idiopathic chronic pancreatitis was more frequent in males (67.6% vs. 48.1%, P=0.07), and was more commonly associated with diabetes mellitus (13.2% vs. none, P=0.047) and steatorrhea (61.5% vs. 16.7%, P=0.069). Pseudocyst (17.1%) and ascites (9.1%) were the most common complications. All children were treated with pancreatic enzyme supplements for pain relief. 57 patients were followed up. With enzyme supplementation, pain relief was present in 32 (56.1%) patients. Of those who did not improve, 10 underwent endotherapy and 15 underwent surgery. Follow up of 8 patients who underwent endotherapy, showed that 5 (62.5%) had relief. Follow up of 11 patients who underwent surgery showed that only 3 (27%) had pain relief. There was no death.
  
  
  CONCLUSIONS
  Idiopathic chronic pancreatitis is the predominant form of chronic pancreatitis in children and adolescents. It can present with or without calcification. The calcific variety is an aggressive disease characterized by early morphological and functional damage to the pancreas.
authors.affiliation: Department of GI Sciences, Christian Medical College, Vellore, Tamil Nadu, India. Correspondence to: Professor Ashok Chacko, Department of G.I. Sciences, Christian Medical College, Vellore, Tamil Nadu, India. gastro@cmcvellore.ac.in.
authors.forename: S D
authors.initials: SD
authors.lastname: Chowdhury
authors.forename: A
authors.initials: A
authors.lastname: Chacko
authors.forename: B S
authors.initials: BS
authors.lastname: Ramakrishna
authors.forename: A K
authors.initials: AK
authors.lastname: Dutta
authors.forename: J
authors.initials: J
authors.lastname: Augustine
authors.forename: A K
authors.initials: AK
authors.lastname: Koshy
authors.forename: E G
authors.initials: EG
authors.lastname: Simon
authors.forename: A J
authors.initials: AJ
authors.lastname: Joseph
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome